PALO VERDE HEALTH CARE DISTRICT REGULAR BOARD OF DIRECTORS MEETING MINUTES August 24, 2016 City Council Chambers

PVHD BOD Meeting Minutes August 24, 2016 Page 1 of 6 PALO VERDE HEALTH CARE DISTRICT REGULAR BOARD OF DIRECTORS MEETING MINUTES August 24, 2016 City Council Chambers Directors Present Administrative Staff Present Trina Sartin, President Ms. Sandra Anaya, CEO Sam Burton, Director Ms. Christa Rohde, Assistant CFO David Brooks, MD, Director TOPIC DISCUSSION ACTION 1.a. Call To Order President Sartin calls the meeting to order at approximately 5:42 p.m. 1.b. Pledge of Allegiance The Pledge of Allegiance was led by Director Brooks. M.D. 1.c. Roll Call Ms. Dakota Doyle conducts Roll Call. All members are present with the exception of Sandra Hudson and Carmela Garnica. 2. Public Comment President Sartin calls for public comment. No public comment. 3. Approval of the Agenda President Sartin presents the Agenda for board consideration and approval. 4. Consent Agenda Director Brooks, motions to approve the Agenda 3; Director Burton seconds. Motion carried unanimously. 4.a. Review and Approval of Minutes from 7/27/2016 5. Medical Executive Committee Presented by Frank Arko, MD.,Chief of Staff 5.a. Verbal Medical Executive Committee Report and Updates President Sartin presents item 4.a. for board consideration and approval. Hossain Sahlolbei, M.D. presents the Medical Executive Committee Report on behalf of Frank Arko, M.D. Hossain Sahlolbei, M.D. reports that there are no Medical Executive Committee updates. Director Burton motions to approve item 4.a.; Director Brooks seconds. Motion carried with President Sartin abstaining. 5.b. Policies and Procedures Aminoglycoside Dosing Protocol Vancomycin Protocol Hossain Sahlolbei, M.D. presents item 5.b. for board consideration and approval in closed session. Director Burton motions to approve item 5.b.; Director Brooks seconds. Prepared by D. Doyle 1

PVHD BOD Meeting Minutes August 24, 2016 Page 2 of 6 5.c. MERP Plan 2016 6. Reports 6.a. Board Report Presented by Trina Sartin, President President Sartin presents item 5.c. for board consideration and approval in closed session. President Sartin thanks the medical staff for all of their support of the hospital during Dr. Arko s time away. In addition, she thanks Administration for their continued improvements and recognizes the challenges they face daily. Ms. Anaya thanks President Sartin for her recognition and comments that Ms. Christa Rohde is the best Chief Financial Officer she s ever worked with. In addition she comments that Ms. Dakota Doyle is doing a superb job in the Human Resources Department given the short amount of time she s been in the department. Motion carried unanimously. Director Brooks motions to approve item 5.c.; Director Burton seconds. Motion carried unanimously. 6.b. Administrative Updates Presented by Sandra Anaya, CEO Ms. Sandra Anaya reports item 6.b. and reports the following: Operations o Held budget meetings with department managers to try and increase their awareness of controlling dollars. o Core measure reports were submitted on time. o Initiated a Customer Service Program to include the Triple Aim Initiative, Studer principles and hourly rounding by nurses. Task Force team has been selected to develop and carry out the program. Goal is to acknowledge each individual s contribution. o Cash tight. Extensive efforts by Christa and crew to catch up on billing, coding and addressing system issues related to the process. Program Updates o Designated Rural Health Status Noridian, the government s healthcare administrator needs to issue a letter designating authorized rural status. Christa is working to get the letter through our Noridian Prepared by D. Doyle 2

PVHD BOD Meeting Minutes August 24, 2016 Page 3 of 6 o o o o o o representative. Dakota is working with the Compliance Team, who will prepare and survey the clinic. PRIME Program [Medi-Cal] A report regarding this program, based on approved plan requirements, will be submitted to CDPH by August 26 th. A second report is due at the end of September. TCPI Program [Medicare] Initiated program planning for patient flow including the referral process. Screening templates have been submitted to Allscripts that will be used for screening and evaluation of patients. Diabetic Grant Program On target with established milestones and reporting. Diabetic Education Program Members of the consortium and the Project Coordinator met August 18 th. Representatives from Riverside will be here intermittently throughout the year. Promotoras will implement teaching on a weekly basis in Blythe. Will also help with any diabetes activities including grants to assist us in sustaining the program. The Riverside representatives will try to help solicit an endocrinologist that will be in Blythe at least once per week. They recognize the need in Blythe. Representatives will also help to certify selected staff as Diabetic Educators. Airgas Contract for renewal Contract is for oxygen cylinders and will provide an approximate savings of $3,000 monthly. Obtaining a memorandum of understanding for natural disaster such as earthquake. Contract is for 7 years. Policy Currently updating clinic policies. Starting to review Swing Bed Prepared by D. Doyle 3

PVHD BOD Meeting Minutes August 24, 2016 Page 4 of 6 o o standards and policy development. Human Resources BETA will be on-site August 30 and 31 st conducting a risk assessment in the Emergency Department. Continue job sharing program: i.e., Patient Financial Counselor is now assisting with billing and TAR completion for case management. Dakota does both HR and Board Assistant. Administrative Assistant has been cross-oriented to QM data collection and monitoring. Plant Operations/Housekeeping Final plans for CT have been submitted to OSHPD. Working with OHSPD on outstanding projects and which projects can be closed out and/or need to be pursued. 6.c. Financial Updates Presented by Christa Rohde, Assistant CFO Ms. Christa Rohde reports item 6.c. and reports the following: Check book balance is approximately $1.8 million dollars. o As a reminder, it takes approximately $2.0 million to run the hospital on a monthly basis. o Payables have been slowed down and will continue to work through vendors and will o slow as much as possible. There are three payrolls between August and September and payrolls are approximately $400,000 each. Two IGT payments coming up; one is $350,000 and the other is $1.2 1.4 million. Low census Cash low at the end of September and October. Daily goal for bills to be out of the door is $360,000 we only get reimbursed for about 24%. Reached out to Rich at HFS to assist us with sending an experienced biller to help temporarily. [Discussion ensues regarding All Scripts and the issues with the system] Dr. Brooks recommends Scribes in the Emergency Department. Ms. Anaya comments that a PA/Scribe will be considered in the future. Prepared by D. Doyle 4

PVHD BOD Meeting Minutes August 24, 2016 Page 5 of 6 7. Action Items 7.a.Airgas Agreement Dakota and Irene have been fantastic in working through a lot of manual work in keying time and validating times from sign in and out sheets. o Returning forms that are incomplete, i.e. time correction, PTO. Working directly with the programmer of the company so any issues are fixed quickly. Employees are manually keying in badge numbers into the new clocks waiting for new cards to come in, estimated one to two payrolls. President Sartin presents item 7.a. for board consideration and approval.. Director Brooks motions to approve item 7.a.; Director Burton seconds. Motion carried unanimously. 7.b. Medhost Proposal 8. Closed Session 8.a. Hospital Quality Assurance Report pursuant to Health & Safety Code 32155 8.b. Conference with Legal Counsel Existing Litigation Government Code 54956.9(d) one case (1) Rutherford et al., v. PVHD, et al, USDC Case No.:EDCV13-01247 JAK (OPx) 9. Report After Closed Session President Sartin requests that item 7.b. be tabled until the next meeting. Dr. Brooks requests clarification of the proposal. Ms. Rohde comments that there is a lot of information in the old system including medical records, audits and financial information. We would like to work out a deal with Med Host so that we can have access to that data. [The board adjourns to closed session at approximately 6:48 p.m.] President Sartin calls the meeting back to order at approximately 6:49 p.m. Director Brooks motions to table item 7.b.; Director Burton seconds. Motion carried unanimously. President Sartin reports that there was no report or action taken in closed session. Prepared by D. Doyle 5

PVHD BOD Meeting Minutes August 24, 2016 Page 6 of 6 10. Adjournment President Sartin adjourns the meeting at 6:50 p.m. Sam Burton, Secretary Prepared by D. Doyle 6

Overflow of 5150 Patient in Med-Surg Department: Administration Function: Provision of Care CEO Approval 08/16 P & P Number: 601.66 MEC Approval 08/16 Policy Protocol Purpose Procedure Board of Directors Approval 09/16 Review Date Initials This policy will define guidelines in accommodating 5150 patients from ER to MS unit. This will provide directions in the care of 5150 patient that require additional coordinated, immediate support from the MS staff. Scope All ER and Med-Surge licensed staff Objectives 1. To accommodate the 5150 patient in Med-Surg Unit 2. Ensure patients safety and close observation 3. Maximize the use of the patient care area when there is a 5150 patient 4. To provide a plan for the mobilization of the resources to respond immediately to behavior outburst of the patient. Definitions Overflow of Patient Excess or surplus of patients not able to be accommodated by an available wait. Policy Palo Verde has developed a contingency plan to be used to assure that 5150 patients in ER are placed in med-surg unit with a sitter once they are cleared by ER MD and while waiting for psych placement. This will ensure safety for both the nurse and patient. The ER RN will continue to oversee the care of the patient and the MS RN will provide immediate assistance in case of behavioral outburst of the patient. Page 1 of 2

Procedure 1. When a 5150 patient is admitted to ER, an ER workup will be done. 2. Once patient is cleared by the ER MD and patient is waiting for psych placement he/she will be transfer to MST unit with a sitter. 3. Nursing supervisor will be notified for MS bed as an overflow. 4. Telemedicine will be schedule / completed. 5. Patient will remain in MS unit with the sitter until the 72 hour hold or a Psych placement becomes available. Forms Attachments References Revisions Owner s Overview of Changes Current Prior Initials 8/16 New New Policy to define guidelines in accommodating 5150 patient NFF From ER to MST. Page 2 of 2

AMENDMENT ABBOTT DIABETES CARE SALES CORPORATION, CONTRACTS & PRICING,1420 Harbor Bay Parkway, Suite 290, Alameda, CA 94502 Shipping Address : Billing Address: Customer PALO VERDE HOSPITAL Name PALO VERDE HOSPITAL Address 250 N 1ST ST Address 250 N 1ST ST City, State, ZIP BLYTHE, CA-92225 City, State, ZIP BLYTHE, CA-92225 Number of Doctors / Beds Phone Customer Number (s) 50190628 Purchase Order No. National Account Affiliation HPG Sales Rep / Territory Tanya Ralston-Engle Customer Point of Contact Rosario Ignacio Amendment Customer (identified above) and Abbott Diabetes Care Sales Corporation. ("ADC"), hereby amend the Agreement dated October 12, 2010 (hereinafter referred to as "Agreement") between the parties under the terms and conditions specified below (this Amendment ). 1. EQUIPMENT Customer and ADC hereby amend the Agreement by adding one or more Products (as specified on the Price Exhibit attached hereto) to be used by Customer pursuant to the terms and conditions of the Agreement. The Price Exhibit attached hereto should be used in conjunction with the Master Price Exhibit to determine total quantities of equipment and/or accessories. ADC agrees to sell or lease directly to Customer, and Customer agrees to purchase or lease directly from ADC. The ADC-owned equipment is identified on the Price Exhibit as Abbott Owned and the Customer-owned equipment is identified on the Price Exhibit Customer Owned. All changes resulting from this Amendment are subject to the Terms and Conditions set forth in the Agreement or added herein. 2. PURCHASE OF STRIPS Customer and ADC hereby amend the Agreement by: a) adding one or more Products; b) changing the current volume and/or price of one or more Products ; c) deleting one or more Products; d) adding an additional customer location; e) or extending the term of the Agreement as indicated in Article 4 below. The parties agree that all Products listed on the Price Exhibit will become part of Price Exhibit of the Agreement upon the Effective Date of this Amendment, and therefore, all said Products shall be subject to the terms and conditions of the Agreement. 3. SHIPPING AND HANDLING CHARGES Shipping and handling shall be as set forth in the Agreement. 4. EXTENSION This Agreement shall continue in effect until October 31, 2017, unless terminiated earlier as set forth within the Agreement. 5. EXHIBIT(S) The attached Exhibit(s) includes one or more of the following: Product Additions Product Deletions Product Changes: Volumes Price Per Test Customer Addition(s) The Amendment is only complete and in effect if accepted and signed by a duly authorized signatory from Abbott Diabetes Care Sales Corporation Any proposal or documents drafted or approved by anyone other than a duly authorized signatory for ADC shall not be considered valid and binding agreements. This Amendment is hereby incorporated into and made a part of the Agreement. Except as expressly amended by this Amendment, the terms and conditions of the Agreement shall remain in full force and effect. AGREED TO AND ACCEPTED THIS: CUSTOMER: ABBOTT DIABETES CARE SALES CORPORATION: Name: Name: Signature/Date: Signature/Date: Title: 2001-2012 Abbott Diabetes Care Sales Corporation Prepared By - Tanya Ralston-Engle : Date Created - 8/24/2016 Title:

AMENDMENT TO THE EMPLOYMENT AGREEMENT WITH SANDRA J. ANAYA The Chief Executive Officer Employment Agreement ( Employment Agreement ) dated August 1, 2016 between the Palo Verde Healthcare District ( District ) and Sandra J. Anaya ( Employee ), is hereby amended as follows: 3. Base Salary. Commencing August 1, 2016, Employee shall receive an annual base salary of One Hundred Eighty Three Thousand Seven Hundred Fifty Dollars ($183,750) payable biweekly every other Friday, subject to all applicable withholdings and deductions. Employee shall receive the amount of Twenty Five thousand ($25,000) per year to be placed in a deferred compensation plan established by the employee. Dated: September, 2016 Dated: September, 2016 District : PALO VERDE HEALTHCARE DISTRICT By Trina Sartin, President. Board of Directors Employee : Sandra J. Anaya, RN 1

1. Standard Code of FPPC Palo Verde Healthcare District Conflict of Interest Code The Political Reform Act of 1974 (Gov. Code, 81000, et seq.) requires each state and local government agency to adopt and promulgate a conflict of interest code. The Palo Verde Healthcare District has adopted heretofore such a code which should be revised and updated. The Fair Political Practices Commission (FPPC) has adopted a regulation (2 Cal. Code of Regs., 18730) that contains the terms of a standard conflict of interest code, which can be incorporated by reference as a district's code. After public notice and hearing the regulation may be amended by the FPPC to conform to amendments in the Political Reform Act. 2. Adoption of Standard Code of FPPC The terms of Title 2, California Code of Regulations, section 18730 and any future amendments to it duly adopted by the FPPC are hereby incorporated by reference. This regulation and the appendix attached hereto designating officials and employees and establishing disclosure categories shall constitute the Conflict of Interest Code of the Palo Verde Healthcare District. This code shall take effect when approved by the Riverside County Board of Supervisors and shall thereupon supersede all prior codes adopted by the Palo Verde Healthcare District. 3. Filing of Statements of Economic Interests Pursuant to Section 4 of the standard code, designated employees set forth in the appendix shall file statements of economic interests with the executive secretary of the Palo Verde Healthcare District. Upon receipt of the statements of the members of the board of directors and the general manager, the executive secretary shall make and retain copies and forward the originals of these statements to the Clerk of the Board of Supervisors for the County of Riverside. Statements for all other designated employees shall be retained by the Palo Verde Healthcare District. District officials who manage public investments as defined by 2 Cal. Code of Regs. 18701(b), are NOT subject to the District s Conflict of Interest Code, but are subject to the disclosure requirements of the Act (Gov. Code, 87200 et seq.; 2 Cal. Code of Regs., 18730(b)(3)). It has been determined that the positions listed below are officials who manage public investments: Members of the Board of Directors Chief Executive Officer Chief Financial Officer Financial Consultant Candidates for the Board of Directors are required to report financial interests through the County Registrar of Voters at the time of filing for election. 2016 Conflict of Interest Code 1 Palo Verde Healthcare District

APPENDIX TO THE CONFLICT OF INTEREST CODE OF THE PALO VERDE HEALTHCARE DISTRICT Designated Employee Disclosure Category Business Office Manager............................ 4 General Counsel................................... 1, 2 Chief Nursing Officer............................... 4 Controller........................................ 1, 2 Human Resources Manager.......................... 4 Manager, HIM..................................... 4 Manager, Information Systems........................ 4 Manager, Laboratory............................... 4 Manager, Materials Management...................... 3 Manager, Nutritional Services........................ 4 Manager, Pharmacy Services......................... 4 Manager, Plant Operations........................... 4 Manager, Quality Assurance/Risk Management........... 4 Plant Operations Coordinator......................... 4 Consultants....................................... * DISCLOSURE CATEGORIES The disclosure categories listed below identify the types of investments, business entities, sources of income, including gifts, loans and travel payments, or real property which the Designated Employee must disclose for each disclosure category to which he or she is assigned: CATEGORY 1: CATEGORY 2: CATEGORY 3: CATEGORY 4: All investments business positions and sources of income, including gifts, loans and travel payments, that do business or own real property within the jurisdiction of the District. All interests in real property which is located in whole or in part within, or not more than two (2) miles outside, the jurisdiction of the District. All Investments, business positions and sources of income, including gifts, loans and travel payments, that provide services, supplies, materials, machinery, vehicles, or equipment of a type utilized by the District. All Investments, business positions and sources of income, including gifts loans and travel payments, that provide services, supplies, materials, vehicles., machinery, or equipment of a type purchased or leased by the Designated Employee s department, unit, or division. 2016 Conflict of Interest Code 2 Palo Verde Healthcare District

Regulations of the Fair Political Practices Commission, Title 2, Division 6, California Code of Regulations 18730 Provisions of Conflict of Interest Codes (a) Incorporation by reference of the terms of this regulation along with the designation of employees and the formulation of disclosure categories in the Appendix referred to below constitute the adoption and promulgation of a conflict of interest code within the meaning of Section 87306 if the terms of this regulation are substituted for terms of a conflict of interest code already in effect. A code so amended or adopted and promulgated requires the reporting of reportable items in a manner substantially equivalent to the requirements of Article 2 of Chapter 7 of the Political Reform Act, Sections 81000, et seq. The requirements of a conflict of interest code are in addition to other requirements of the Political Reform Act, such as the general prohibition against conflicts of interest contained in Section 87100, and to other state or local laws pertaining to conflicts of interest. (b) The terms of a conflict of interest code amended or adopted and promulgated pursuant to this regulation are as follows: (1) Definitions. The definitions contained in the Political Reform Act of 1974, regulations of the Fair Political Practices Commission (Regulations, 18110, et seq.), and any amendments to the Act or regulations, are incorporated by reference into this conflict of interest code. (2) Designated Employees. The persons holding positions listed in the Appendix are designated employees. It has been determined that these persons make or participate in the making of decisions which may foreseeably have a material effect on economic interests. (3) Disclosure Categories. This code does not establish any disclosure obligation for those designated employees who are also specified in Section 87200 if they are designated in this code in that same capacity or if the geographical jurisdiction of this agency is the same as or is wholly included within the jurisdiction in which those persons must report their economic interests pursuant to article 2 of chapter 7 of the Political Reform Act, Sections 87200, et seq. In addition, this code does not establish any disclosure obligation for any designated employees who are designated in a conflict of interest code for another agency, if all of the following apply: (A) The geographical jurisdiction of this agency is the same as or is wholly included within the jurisdiction of the other agency; (B) The disclosure assigned in the code of the other agency is the same as that required under article 2 of chapter 7 of the Political Reform Act, Section 87200; and (C) The filing officer is the same for both agencies. (1) Such persons are covered by this code for disqualification purposes only. With respect to all other designated employees, the disclosure categories set forth in the Appendix specify which kinds of 2016 Conflict of Interest Code 3 Palo Verde Healthcare District

economic interests are reportable. Such a designated employee shall disclose in his or her statement of economic interests those economic interests he or she has which are of the kind described in the disclosure categories to which he or she is assigned in the Appendix. It has been determined that the economic interests set forth in a designated employee's disclosure categories are the kinds of economic interests which he or she foreseeably can affect materially through the conduct of his or her office. (4) Statements of Economic Interests: Place of Filing. The code reviewing body shall instruct all designated employees within its code to file statements of economic interests with the agency or with the code reviewing body, as provided by the code reviewing body in the agency's conflict of interest code. (2) (5) Statements of Economic Interests: Time of Filing. (A) Initial Statements. All designated employees employed by the agency on the effective date of this code, as originally adopted, promulgated and approved by the code reviewing body, shall file statements within 30 days after the effective date of this code. Thereafter, each person already in a position when it is designated by an amendment to this code shall file an initial statement within 30 days after the effective date of the amendment. (B) Assuming Office Statements. All persons assuming designated positions after the effective date of this code shall file statements within 30 days after assuming the designated positions, or if subject to State Senate confirmation, 30 days after being nominated or appointed. (C) Annual Statements. All designated employees shall file statements no later than April 1. If a person reports for military service as defined in the Servicemember's Civil Relief Act, the deadline for the annual statement of economic interests is 30 days following his or her return to office, provided the person, or someone authorized to represent the person's interests, notifies the filing officer in writing prior to the applicable filing deadline that he or she is subject to that federal statute and is unable to meet the applicable deadline, and provides the filing officer verification of his or her military status. (D) Leaving Office Statements. All persons who leave designated positions shall file statements within 30 days after leaving office. (5.5) Statements for Persons Who Resign Prior to Assuming Office. Any person who resigns within 12 months of initial appointment, or within 30 days of the date of notice provided by the filing officer to file an assuming office statement, is not deemed to have assumed office or left office, provided he or she did not make or participate in the making of, or use his or her position to influence any decision and did not receive or become entitled to receive any form of payment as a result of his or her appointment. Such persons shall not file either an assuming or leaving office statement. (A) Any person who resigns a position within 30 days of the date of a notice from the filing officer shall do both of the following: (1) File a written resignation with the appointing power; and (2) File a written statement with the filing officer declaring under penalty of perjury that during the period between appointment and resignation he or she did not make, participate in the making, or use the position to influence any decision of the agency or receive, or become entitled to receive, any form of payment by virtue of being appointed to the position. 2016 Conflict of Interest Code 4 Palo Verde Healthcare District

(6) Contents of and Period Covered by Statements of Economic Interests. (A) Contents of Initial Statements. Initial statements shall disclose any reportable investments, interests in real property and business positions held on the effective date of the code and income received during the 12 months prior to the effective date of the code. (B) Contents of Assuming Office Statements. Assuming office statements shall disclose any reportable investments, interests in real property and business positions held on the date of assuming office or, if subject to State Senate confirmation or appointment, on the date of nomination, and income received during the 12 months prior to the date of assuming office or the date of being appointed or nominated, respectively. (C) Contents of Annual Statements. Annual statements shall disclose any reportable investments, interests in real property, income and business positions held or received during the previous calendar year provided, however, that the period covered by an employee's first annual statement shall begin on the effective date of the code or the date of assuming office whichever is later, or for a board or commission member subject to Section 87302.6, the day after the closing date of the most recent statement filed by the member pursuant to Regulation 18754. (D) Contents of Leaving Office Statements. Leaving office statements shall disclose reportable investments, interests in real property, income and business positions held or received during the period between the closing date of the last statement filed and the date of leaving office. (7) Manner of Reporting. Statements of economic interests shall be made on forms prescribed by the Fair Political Practices Commission and supplied by the agency, and shall contain the following information: (A) Investment and Real Property Disclosure. When an investment or an interest in real property (3) is required to be reported, (4) the statement shall contain the following: 1. A statement of the nature of the investment or interest; 2. The name of the business entity in which each investment is held, and a general description of the business activity in which the business entity is engaged; 3. The address or other precise location of the real property; 4. A statement whether the fair market value of the investment or interest in real property equals or exceeds $2,000, exceeds $10,000, exceeds $100,000, or exceeds $1,000,000. (B) Personal Income Disclosure. When personal income is required to be reported, (5) the statement shall contain: 1. The name and address of each source of income aggregating $500 or more in value, or $50 or more in value if the income was a gift, and a general description of the business activity, if any, of each source; 2. A statement whether the aggregate value of income from each source, or in the case of a loan, the highest amount owed to each source, was $1,000 or less, greater than $1,000, greater than $10,000, or greater than $100,000; 2016 Conflict of Interest Code 5 Palo Verde Healthcare District

3. A description of the consideration, if any, for which the income was received; 4. In the case of a gift, the name, address and business activity of the donor and any intermediary through which the gift was made; a description of the gift; the amount or value of the gift; and the date on which the gift was received; 5. In the case of a loan, the annual interest rate and the security, if any, given for the loan and the term of the loan. (C) Business Entity Income Disclosure. When income of a business entity, including income of a sole proprietorship, is required to be reported, (6) the statement shall contain: 1. The name, address, and a general description of the business activity of the business entity; 2. The name of every person from whom the business entity received payments if the filer's pro rata share of gross receipts from such person was equal to or greater than $10,000. (D) Business Position Disclosure. When business positions are required to be reported, a designated employee shall list the name and address of each business entity in which he or she is a director, officer, partner, trustee, employee, or in which he or she holds any position of management, a description of the business activity in which the business entity is engaged, and the designated employee's position with the business entity. (E) Acquisition or Disposal During Reporting Period. In the case of an annual or leaving office statement, if an investment or an interest in real property was partially or wholly acquired or disposed of during the period covered by the statement, the statement shall contain the date of acquisition or disposal. (8) Prohibition on Receipt of Honoraria. (A) No member of a state board or commission, and no designated employee of a state or local government agency, shall accept any honorarium from any source, if the member or employee would be required to report the receipt of income or gifts from that source on his or her statement of economic interests. This section shall not apply to any part-time member of the governing board of any public institution of higher education, unless the member is also an elected official. Subdivisions (a), (b), and (c) of Section 89501 shall apply to the prohibitions in this section. This section shall not limit or prohibit payments, advances, or reimbursements for travel and related lodging and subsistence authorized by Section 89506. (8.1) Prohibition on Receipt of Gifts in Excess of $460. (A) No member of a state board or commission, and no designated employee of a state or local government agency, shall accept gifts with a total value of more than $460 in a calendar year from any single source, if the member or employee would be required to report the receipt of income or gifts from that source on his or her statement of economic interests. This section shall not apply to any part-time member of the governing board of any public institution of higher education, unless the member is also an elected official. Subdivisions (e), (f), and (g) of Section 89503 shall apply to the prohibitions in this section. 2016 Conflict of Interest Code 6 Palo Verde Healthcare District

(8.2) Section 8.2. Loans to Public Officials. (A) No elected officer of a state or local government agency shall, from the date of his or her election to office through the date that he or she vacates office, receive a personal loan from any officer, employee, member, or consultant of the state or local government agency in which the elected officer holds office or over which the elected officer's agency has direction and control. (B) No public official who is exempt from the state civil service system pursuant to subdivisions (c), (d), (e), (f), and (g) of Section 4 of Article VII of the Constitution shall, while he or she holds office, receive a personal loan from any officer, employee, member, or consultant of the state or local government agency in which the public official holds office or over which the public official's agency has direction and control. This subdivision shall not apply to loans made to a public official whose duties are solely secretarial, clerical, or manual. (C) No elected officer of a state or local government agency shall, from the date of his or her election to office through the date that he or she vacates office, receive a personal loan from any person who has a contract with the state or local government agency to which that elected officer has been elected or over which that elected officer's agency has direction and control. This subdivision shall not apply to loans made by banks or other financial institutions or to any indebtedness created as part of a retail installment or credit card transaction, if the loan is made or the indebtedness created in the lender's regular course of business on terms available to members of the public without regard to the elected officer's official status. (D) No public official who is exempt from the state civil service system pursuant to subdivisions (c), (d), (e), (f), and (g) of Section 4 of Article VII of the Constitution shall, while he or she holds office, receive a personal loan from any person who has a contract with the state or local government agency to which that elected officer has been elected or over which that elected officer's agency has direction and control. This subdivision shall not apply to loans made by banks or other financial institutions or to any indebtedness created as part of a retail installment or credit card transaction, if the loan is made or the indebtedness created in the lender's regular course of business on terms available to members of the public without regard to the elected officer's official status. This subdivision shall not apply to loans made to a public official whose duties are solely secretarial, clerical, or manual. (E) This section shall not apply to the following: 1. Loans made to the campaign committee of an elected officer or candidate for elective office. 2. Loans made by a public official's spouse, child, parent, grandparent, grandchild, brother, sister, parent-in-law, brother-in-law, sister-in-law, nephew, niece, aunt, uncle, or first cousin, or the spouse of any such persons, provided that the person making the loan is not acting as an agent or intermediary for any person not otherwise exempted under this section. 3. Loans from a person which, in the aggregate, do not exceed $500 at any given time. 4. Loans made, or offered in writing, before January 1, 1998. (8.3) Loan Terms. (A) Except as set forth in subdivision (B), no elected officer of a state or local government agency shall, from the date of his or her election to office through the date he or she vacates office, receive a personal loan of $500 or more, except when the loan is in writing and clearly states the terms of the loan, including the parties to the loan agreement, date of the loan, amount of the loan, term of 2016 Conflict of Interest Code 7 Palo Verde Healthcare District

the loan, date or dates when payments shall be due on the loan and the amount of the payments, and the rate of interest paid on the loan. (B) This section shall not apply to the following types of loans: 1. Loans made to the campaign committee of the elected officer. 2. Loans made to the elected officer by his or her spouse, child, parent, grandparent, grandchild, brother, sister, parent-in-law, brother-in-law, sister-in-law, nephew, niece, aunt, uncle, or first cousin, or the spouse of any such person, provided that the person making the loan is not acting as an agent or intermediary for any person not otherwise exempted under this section. 3. Loans made, or offered in writing, before January 1, 1998. (C) Nothing in this section shall exempt any person from any other provision of Title 9 of the Government Code. (8.4) Personal Loans. (A) Except as set forth in subdivision (B), a personal loan received by any designated employee shall become a gift to the designated employee for the purposes of this section in the following circumstances: 1. If the loan has a defined date or dates for repayment, when the statute of limitations for filing an action for default has expired. 2. If the loan has no defined date or dates for repayment, when one year has elapsed from the later of the following: a. The date the loan was made. b. The date the last payment of $100 or more was made on the loan. c. The date upon which the debtor has made payments on the loan aggregating to less than $250 during the previous 12 months. (B) This section shall not apply to the following types of loans: office. 1. A loan made to the campaign committee of an elected officer or a candidate for elective 2. A loan that would otherwise not be a gift as defined in this title. 3. A loan that would otherwise be a gift as set forth under subdivision (A), but on which the creditor has taken reasonable action to collect the balance due. 4. A loan that would otherwise be a gift as set forth under subdivision (A), but on which the creditor, based on reasonable business considerations, has not undertaken collection action. Except in a criminal action, a creditor who claims that a loan is not a gift on the basis of this paragraph has the burden of proving that the decision for not taking collection action was based on reasonable business considerations. 5. A loan made to a debtor who has filed for bankruptcy and the loan is ultimately discharged in bankruptcy. 2016 Conflict of Interest Code 8 Palo Verde Healthcare District

(C) Nothing in this section shall exempt any person from any other provisions of Title 9 of the Government Code. (9) Disqualification. No designated employee shall make, participate in making, or in any way attempt to use his or her official position to influence the making of any governmental decision which he or she knows or has reason to know will have a reasonably foreseeable material financial effect, distinguishable from its effect on the public generally, on the official or a member of his or her immediate family or on: (A) Any business entity in which the designated employee has a direct or indirect investment worth $2,000 or more; (B) Any real property in which the designated employee has a direct or indirect interest worth $2,000 or more; (C) Any source of income, other than gifts and other than loans by a commercial lending institution in the regular course of business on terms available to the public without regard to official status, aggregating $500 or more in value provided to, received by or promised to the designated employee within 12 months prior to the time when the decision is made; (D) Any business entity in which the designated employee is a director, officer, partner, trustee, employee, or holds any position of management; or (E) Any donor of, or any intermediary or agent for a donor of, a gift or gifts aggregating $460 or more provided to, received by, or promised to the designated employee within 12 months prior to the time when the decision is made. (9.3) Legally Required Participation. No designated employee shall be prevented from making or participating in the making of any decision to the extent his or her participation is legally required for the decision to be made. The fact that the vote of a designated employee who is on a voting body is needed to break a tie does not make his or her participation legally required for purposes of this section. (9.5) Disqualification of State Officers and Employees. In addition to the general disqualification provisions of section 9, no state administrative official shall make, participate in making, or use his or her official position to influence any governmental decision directly relating to any contract where the state administrative official knows or has reason to know that any party to the contract is a person with whom the state administrative official, or any member of his or her immediate family has, within 12 months prior to the time when the official action is to be taken: (A) Engaged in a business transaction or transactions on terms not available to members of the public, regarding any investment or interest in real property; or, (B) Engaged in a business transaction or transactions on terms not available to members of the public regarding the rendering of goods or services totaling in value $1,000 or more. 2016 Conflict of Interest Code 9 Palo Verde Healthcare District

(10) Disclosure of Disqualifying Interest. When a designated employee determines that he or she should not make a governmental decision because he or she has a disqualifying interest in it, the determination not to act may be accompanied by disclosure of the disqualifying interest. (11) Assistance of the Commission and Counsel. Any designated employee who is unsure of his or her duties under this code may request assistance from the Fair Political Practices Commission pursuant to Government Code Section 83114 and Regulations 18329 and 18329.5 or from the attorney for his or her agency, provided that nothing in this section requires the attorney for the agency to issue any formal or informal opinion. (12) Violations. This code has the force and effect of law. Designated employees violating any provision of this code are subject to the administrative, criminal and civil sanctions provided in the Political Reform Act, Sections 81000-91014. In addition, a decision in relation to which a violation of the disqualification provisions of this code or of Section 87100 or 87450 has occurred may be set aside as void pursuant to Section 91003. (1) Designated employees who are required to file statements of economic interests under any other agency's conflict of interest code, or under article 2 for a different jurisdiction, may expand their statement of economic interests to cover reportable interests in both jurisdictions, and file copies of this expanded statement with both entities in lieu of filing separate and distinct statements, provided that each copy of such expanded statement filed in place of an original is signed and verified by the designated employee as if it were an original. See Government Code Section 81004. (2) See Government Code Section 81010 and Regulation 18115 for the duties of filing officers and persons in agencies who make and retain copies of statements and forward the originals to the filing officer. (3) For the purpose of disclosure only (not disqualification), an interest in real property does not include the principal residence of the filer. (4) Investments and interests in real property which have a fair market value of less than $2,000 are not investments and interests in real property within the meaning of the Political Reform Act. However, investments or interests in real property of an individual include those held by the individual's spouse and dependent children as well as a pro rata share of any investment or interest in real property of any business entity or trust in which the individual, spouse and dependent children own, in the aggregate, a direct, indirect or beneficial interest of 10 percent or greater. (5) A designated employee's income includes his or her community property interest in the income of his or her spouse but does not include salary or reimbursement for expenses received from a state, local or federal government agency. (6) Income of a business entity is reportable if the direct, indirect or beneficial interest of the filer and the filer's spouse in the business entity aggregates a 10 percent or greater interest. In addition, the disclosure of persons who are clients or customers of a business entity is required only if the clients or customers are within one of the disclosure categories of the filer. 2016 Conflict of Interest Code 10 Palo Verde Healthcare District